Thriving with PCOS with Stacey Roberts, ND – #26

0:27 Charlene Lincoln: Welcome back to another episode of The Fertility Hour. You know what, I’m terrible at promoting The Fertility Hour but it’s so important that we get your support. So FertilityHour.com is our website. There you can download a free report, How to Restore Your Fertility. Share whatever episodes resonate with you on your social media accounts, share them with friends, family, loved ones. Make comments, ask questions. I’ll be looking out for them, and I really appreciate your support.

So today, I’m really excited. I have Stacey “the babymaker” Roberts. I love that. Stacey is a physical therapist turner herbalist and naturopath since 1989. She consults with individuals and couples to create a specialized individualized natural fertility program to enhance health and help couples conceive. She has assisted couples in over 32 countries, helping them to improve their overall health and well-being by addressing their physical, physiological, and emotional health using complementary medicine products and services. Her clinic’s natural fertility approach has been associated with 7000 babies being born. This prompted Stacy to formalize her approach for patients into the Five Step Fertility Solution available in her book ‘The Fertility Bible’, and many of these couples were told that they would never have a child. She continues to develop their enhanced programs to optimize women’s health and hormones. Her Five Step Program also addresses prenatal and postnatal care, overall hormonal health and function and nutritional support. She’s also developed an exclusive highly detailed and informative program for practitioners called The Fertility Mentoring Program. She’s co-authored 7 other books. She speaks internationally. She’s been featured on Oprah. I love that. So, thank you so much for being here, Stacey.

Stacey Roberts: It’s an absolute pleasure. Thank you for having me.

2:44 CL: You’re welcome. I know that you speak, treat and mentor on many, many different conditions but kind of one thing that’s been coming up is PCOS, so that’s what I approached you about. Let’s have a conversation about PCOS because I think there’s a ton of information out there and then when there’s a lot of information online, there’s a lot of misinformation, misconception. I could imagine if you get diagnosed with PCOS, it might hit you like a semi-truck and you feel like a lot of fears come up and of course, like all of us, you just run to the internet and start going to ‘Dr. Google’ and figuring out what the heck is going on, what’s my future going to look like with this, what are my options. So I want to kind of go through a lot of that noise and make a plan for people and inspire women. I mean, is it true PCOS can make it challenging to become a parent, but you could definitely become a parent, have a healthy baby, and have a healthy pregnancy?

SR: Absolutely. There was a friend of mine in the States back and me not having any knowledge of any fertility issues before. She was diagnosed with pcos. I remember I was probably in my early 20s and I remember her family was very upset about it because she was told that she probably wouldn’t be able to have children in the future and everybody was just really, really down and worried about her. So she never thought she could have children. She got married and all of a sudden six months into the marriage, bam, she became pregnant. Then about a year and a half later, again became pregnant. She did have polycystic ovaries and she never had any problems becoming pregnant. So it’s not necessarily a guarantee that women are going to have issues when they have polycystic ovaries in regards to becoming pregnant, but certainly can be an issue.

4:46 CL: That is good to know. Is the only way to definitively diagnose PCOS is through an ultrasound? Because what I’ve read, some women go, “God, I had to really beg my doctor to give me an ultrasound.” Or are doctors looking at all the other signs and symptoms and going, “This is the condition you have”?

SR: Well, what’s interesting about is there’s not agreement across the board as far as the medical profession about how to diagnose polycystic ovaries. Some doctors believe that the ovaries themselves need to be polycystic. Some doctors believe that the androgens need to be elevated and it doesn’t matter if the ovaries are polycystic or not. And now they’ve come up with kind of a grading scale of different levels combining all those things. Some different associations have come up with different ways for doctors and say they’re a grade 1, grade 2, grade 3, etc. Some of those will involve taking an ultrasound to see if they have the polycystic ovary morphology, if you will, so that the ovaries look polycystic. But then the others will involve what symptoms are there plus their hormone levels. So it really is, hopefully, being streamlined now into something a little bit more — I don’t want to say precise because when they would just look at a woman and say “Oh, you’re overweight and you have irregular cycles. You must have polycystic ovaries.” Now they’re opening that up and making it a much more broad definition with distinct parameters to be able to decide how to diagnose. But that’s not even across the board. So it really depends on the specific doctor and their knowledge and what they’re most comfortable with.

6:27 CL: And what about you in your expert opinion, what are the parameters where you can determine that a woman has PCOS?

SR: Well, they usually come in to see me with the diagnosis, first of all. But if I’m suspicious, so let’s say they have unexplained fertility issues or they haven’t been to a doctor and they come to me first, some of telltale signs would be irregular cycles, the excessive hair growth, issues with acne usually on the neck or around the chin or on the back more of like a cystic acne versus just getting around their chin during the cycle. The hair loss like alopecia, if you will, androgenic alopecia where they have certain areas where it’s kind of a male pattern baldness. That usually comes later; it doesn’t usually come in the early stages in regards to polycystic ovaries, but it can happen. So those types of things will start to make me think, “Hmm, does this person present with polycystic ovaries?” But with every person that I’m seeing, I’m really not focusing on their diagnosis. Whenever they come and see me, I’m focusing on, “Okay, that’s a bit of information for me.” But I want to see what they’re underlying issues are.

Because when you think about polycystic ovaries really, Charlene, it’s not really a separate disease. It’s a bunch of symptoms which have been labeled as polycystic ovaries. So the vast majority of women with these symptoms will have underlying issues with glucose metabolism or insulin resistance which, for your listeners, that would be someone who’s maybe prediabetic or someone who has difficulty when they eat carbs or sugar and their body is not utilizing that sufficiently as it could.

Then a diet and lifestyle, like we’re unfortunately used to in the United States and somewhat in Australia, can exacerbate that by being high in carbs, low in protein, low in good fats, etc. So, does that answer your question? I don’t really look to specifically diagnose anyway but to say, “Okay, these are the symptoms that make me think there might be polycystic ovaries involved.” But even when that’s the case, I don’t have a person coming in and say “Polycystic ovaries, you need these herbs,” right? I look at what the underlying issues are because there are so many different presentations of polycystic ovaries and I want to make sure that I’m giving them what’s right for their body and their system.

8:53CL: It absolutely makes sense. I practice Chinese medicine and people can present and come in with migraine symptoms. There’s never going to be like, “Oh, here’s the whatever prescriptive formula for that.” I mean, we’re all individuals and so it’s going to present differently.

SR: Absolutely.

9:11 CL: When we’re talking about kind of one of the key factors is the insulin resistance, diet obviously is going to be foundational in treating this. I’m thinking of like paleo, keto, things like that that really are managing blood sugar. If you really had to make it simple for someone, “follow this diet” or I’m assuming it’s a little bit more individualized than that. But give us some guidelines on the diet.

SR: Sure. It is and it isn’t. What I do in my practice is I don’t like to give a specific diet and I don’t like to say eat paleo because again, I think we’re putting people into slots. So how I look at it is I go, “okay,” well they really need an anti-inflammatory eating plan and so does everyone that walks the face of the earth, right? But these people in particular, because they might have underlying insulin resistance, but they could have issues which is glucose metabolism, not diagnosed insulin resistance, and that glucose metabolism may be due to a sluggish thyroid because then if the thyroid is sluggish, the liver might be sluggish and then the liver is not metabolizing or using that glucose for energy as quickly as it should.

So I’m going to, again, want to make sure that my patients are eating an anti-inflammatory eating plan which could be paleo, it could be Mediterranean, it could be any of those that are decreasing the carbohydrates, not necessarily eliminating them but decreasing them, teaching them how to choose the best carbohydrates for them because a lot of people think, “Well, I’ve given up carbs,” but then they’re still eating salad and vegetables and all that. Well, those are carbs, but those are good carbs. So we want to teach the difference between the good carbs and the carbs that are not necessarily good for that person. And eliminating sugar as an anti-inflammatory step for sure. Then making sure that their protein and good fats are in good balance for their particular situation.

And if somebody comes to me who’s a vegetarian, that’s going be a different eating plan that I’m going to work with them on than if they’re coming to me and they’re a meat eater. So it just, again, depends on the situation but if I had somebody in front of me, honestly, I would say the book is actually no longer called ‘The Fertility Bible,’ it’s called ‘The Baby Maker’s Guide to Getting Pregnant: Featuring the Five Step Fertility Solution’ and the first step in that is an optimal eating plan. I explain to them the importance of low glycemic carbohydrates, optimal protein and good fats.

And once they get that concept and I critique them so that they can look at a label or understand what a certain food is doing for them, it’s really then straightforward from there. So then within a Paleo diet or within a Mediterranean diet, they can choose the foods that they know that are going to be better for them.

12:00 CL: Makes sense. This just came up. I know to some it would be extreme but when I was pregnant, I was diagnosed with gestational diabetes and so I was using that, you know, you prick and you test your glucose. I was interviewing William Davis, he’s the author of Wheat Belly and I guess one of his things is you test your blood before you eat and then 30 minutes after and just make sure that the numbers stay the same. Do you ever recommend that to someone just to kind of monitor that their blood sugar is staying stable with the choices that they’re making?

SR: That certainly can be something that patients who I haven’t had to do that and I think most likely because my patients are, again, they probably wouldn’t have really understood that they had polycystic ovaries unless they were trying to become pregnant. Or potentially there’s a small percentage though that are diagnosed as a teenager and then put on the pill and then they just kind of forget about it. So that small percentage might come to me and say, “Look, I know that I had polycystic ovaries and I just don’t want to have trouble getting pregnant,” or that type of thing. But early on in their life basically that a lot of times even monitoring their glucose levels isn’t going to give us that much information because they’re not so insulin resistant that they are having significant issues with high levels of glucose. So in my practice I haven’t had a need to do that unless someone has come to me and they are diabetic, or very much on the border and they’re pre-diabetic where it’s going to be very important for them to monitor it anyways.

How we will monitor that change in blood glucose level or managing the insulin better is how they’re presenting. Are their cycles regulating? Do they notice that they have less of the symptoms that they had previously? If ultrasounds are done, are they a less polycystic ovary in nature? And certainly I think sometimes my patients, well, many times they appreciate that that we’re not doing a lot of different testing on a daily basis like looking at the blood sugar draw, simply because it’s just another thing for them to have to think about when they’re trying to become pregnant. I’m asking them to take their temperature, I’m asking them to eat a certain way. I’m asking them to learn these other things. So I try to keep those suggestions and requirements, if you will, to be a part of the program to a minimum, but that patient still sees the progress. So that’s why we do temperature charting so they can watch the changes in the temperature because PCOS oftentimes, although not 100 percent across the board, will have specific low temperatures related to less than optimal thyroid function or very erratic temperatures if they don’t have a cycle at all or very regular cycles. I’ve had women with polycystic ovaries not have one period on our program and still become pregnant.

So if we did that by monitoring their temperature chart and seeing when they’re probably ovulating, but progesterone may not be coming in to get that big rise in temperature, and then I show them, “Okay, so when you see this pattern, this is when you time intercourse,” and they become pregnant without even having a period.

15:12 CL: That’s really interesting. So the cervical lining never has to necessarily shed.

SR: Correct

15:19 CL: Okay. Well, that is good to know. It’s so interesting. I could imagine it would be quite confusing. I have a question relating to that. So say that a woman was diagnosed early on with PCOS and then she was put on the pill and metformin took control of the glucose levels and then she is on it for a number of years. Unfortunately, some women are on it a decade or more to deal with it. And then they want to start a family and they go to a functional medicine practitioner, integrative, holistic and then we’re addressing thyroid issues, adrenal issues, changing up the whole diet, exercise. I think sometimes people get confused. “My doctor wasn’t really going into any of this.” And some go, “Wait, now I have to do all this stuff.” Unfortunately, I’m not here to beat up conventional medicine but I mean that’s a little bit frustrating that that’s the treatment or protocol.

SR: Oh, it’s a shame. It’ an absolute shame. When you think about it, what an opportunity for that teenager who’s going in and is being told that she has polycystic ovaries. What an amazing opportunity for a learning experience for them to even if they just talked about eating plan, even if they just talked about making sure that you’re exercising, those two big things which are two of the five steps in our Five-Step Fertility Solution, would do wonders for the teenager. But what happens is, they then get put on the pill and then have a regular cycle which they think is a normal cycle. And again, nobody is telling them that it’s not really a cycle, you’re just kind of skipping that ovulation, that type of thing. But you’re getting to bleed. So then when they come off the pill then they go back to the way they were and sometimes worse, sometimes a little bit better. But then all those years that they’re on the pill, they could have been doing things to reverse this condition or at least significantly decrease the issues related to it. So I think it’s a missed opportunity and it makes me kind of sad when I think about it, actually.

17:38 CL: It makes me really sad, yeah.

SR: But thankfully, the more of these types of things that you’re doing and the awareness that I’m doing which we’re making people more aware that they can be more proactive than just taking the pill and pretending like it’s not there.

17:53 CL: That’s what we’re here for. So a woman listening is on the pill, she wants to start a family. She’s been on metformin for a number of years and obviously she has to get off the pill and she wants to start a family. What are we talking, like what are kind of first steps? The dietary changes?

SR: Well, if she was coming to me to say, “Look, I’m on the pill now and I’d like to get off it and start a family, and I’m also taking metformin,” first thing that I would say is, “Well, let’s keep you on the pill for another month or so while we start this program.” As we take the pill away, I don’t know how she’s going to react. Right? So I want to try to support her for a short period of time while she’s taking that medication to give her a little bit of foundational base of support, so that when she comes off the pill, hopefully there’s not a huge swing in symptoms. And those symptoms being things that women most worry about like the excessive hair growth and the acne and things like that. Certainly we want physiological support as well, so to support that underlying potential insulin resistance and hormonal imbalance that could be there as well. But the patients don’t often understand that thing. They understand what they see in the mirror and they are definitely afraid of not wanting to get that acne back that they have before. Or they want a regular cycle so they can become pregnant.

So we kind of focus in and work on those things and then after that first month, then we talk about coming off the pill and then we are monitoring their temperature charts and after a month or so we do some blood tests to see where their hormone levels are at. And then we tweak the formula in the program really to fit them as their body changes coming off the pill.

Now the metformin is interesting because oftentimes they, thankfully, at least from my practice I haven’t seen them being put on that as a teenager, and usually they’re put on that relatively when they find out they want to become pregnant and it’s not happening and then they are diagnosed with polycystic ovaries and then they’re put on metformin. There are so many other opportunities or options besides metformin; however, there are things that we can also do if they don’t want to come off the metformin because let’s say it helped them lose weight and they wanted to stay on the metformin. So we can support the liver and we can make sure that they’re getting their B vitamins because metformin will deplete the body of folic acid and other B vitamins, etc. So we can help support them as well. But if they wanted to come off the metformin as well, because it hasn’t been deemed as safe during pregnancy, then we would look at things like something as simple as apple cider vinegar which has been shown to work just as well for optimizing glucose levels as drugs like metformin. We can look at adding cinnamon to their diet and to their tea and things like that or as a potential herb.

We can look at NAC (N-acetylcysteine) which has been put up against metformin in certain studies and shown to be able to create the same type of change in the system as metformin does. So there are a lot of different opportunities for the patient who’s coming to see me and then I discussed all these options and say which one seems like it would be the most beneficial for you, which one would you feel that you would be most able to be compliant with it and do for a longer term. Because I want them to think of this as a long-term relationship and a long-term commitment to their health and to themselves. And oftentimes I see that metformin, after they’re on it for a couple of years, it doesn’t seem to have a very impactful effect as it did when they first went on it.

21:32 CL: I would think that if women are coming to you, then they’re pretty excited that there are natural options that seem to work just as effectively. Of course, why not? That’s why they’re searching you out to get that information. Let’s see, I have some questions that came in and let’s go through them. Let me pull them up right here. Okay. “I’ve been on the pill for 8 years to control my PCOS. Recently I’ve been reading out natural therapies. I really want to start a family in the next year. Is it really possible to control my symptoms naturally? Why didn’t my doctor present these options to me?” Okay, well, we talked a little bit about this but if there’s anything you want to kind of add to this.

SR: I would just say I’ve been asked that question about “why didn’t my doctor tell me?” and I have no idea. The only real answer I can give them is they didn’t learn that in medical school; it’s not a part of their focus versus the natural aspects are a part of our focus and physicians don’t necessarily believe that what we do will work even though it is supported by research. So my answer to them is: I don’t know. I wish they would have said something to you in the past.

But yes, women can manage the polycystic ovaries and even reverse the polycystic ovary morphology, meaning their ovaries can return to looking normal in some cases with just natural remedies, but it needs to be a commitment to yourself to follow a healthier eating plan and managed by supplementation versus taking a pill to regulate your cycle. So it does rely on self-commitment to a program and it is. That’s a lot more involved in it and frankly it’s more effort as well.

23:22 CL: Yes, absolutely. Another question that came in was asking about diet. We did talk about the diet thing. When you’re having glucose balancing issues, do you have a strong sweet tooth? Because you’re craving kind of like simple carbohydrates, sweets or whatever to manage your energy and mood and things like that. Is there any helpful thing? I know increasing like protein and saturated fats in the diet can help a little bit of that. Maybe I’m asking for myself, I’m always kind of am battling that where I have to really, okay, manage the sugar cravings that come up and I eat plenty of protein and fats.

SR: Well, two things that I find across the board with my patients is if their gut health is not where it needs to be, meaning that their good bacteria is out of balance with the bad bacteria, then a good quality probiotic with a decent amount of CFUs or strains in the product will help and that’s been shown to decrease inflammation in the gut and also decrease sugar cravings for some people. The other thing that I find for some people that have the sugar cravings is if they start off with a good smoothie in the morning that has good natural sugars like fruit in it along with balancing that with some protein and good fat, they have less of a tendency to crave that sugar throughout the day. Also, if they start out with something like, you know, you being in the US you know about bulletproof coffee, right? So if they start off with like something similar to bulletproof coffee or tea, meaning instead of adding all the garbage to their coffee like sugar and creamers and all that, they add some organic butter or some coconut oil or things like that, that will also help to regulate their blood sugar levels. Seeming to do it earlier in the day seems to help fend off the cravings throughout the day as well. And staying away from the chocolate or even if it’s chocolate that’s good for us like dark chocolate in the evenings, that seems to also contribute to more sugar cravings the next day. The first thing is to get rid of as much added sugar as we can in our diet, maximize their protein and good fats, and then look at those other things.

The kind of weird, quirky things that people could try if they’re trying to do things. There’s a herb called Gymnema which in its tincture form if you put that on your tongue before you ingest sugar, the sugar tastes horrible. So it’s kind of it’s that pattern interrupt like if it’s more of a behavioral thing. If you can remember to put that Gymnema on the tongue before having that sugar, it will kind of interrupt that kind of unconscious pattern for wanting that. But I think we don’t often think of our gut as the source of sugar cravings, but those little bacteria that want that excess sugar to keep the fungus or the thrush or the candida growing, we become the puppet, right? They really kind of take over and consciously we know we shouldn’t be having this sugar but we’re still going for it. That’s where it oftentimes is a gut issue that needs to be addressed.

26:37 CL: Well, Stacey, that really resonated with me because I do the bulletproof and different things and it just doesn’t really seem to help, but that really resonated with me about the gut bacteria. It all goes back to the gut.

SR: So many things do, right.

26:52 CL: It really does, I know. Anyways, take care of your microbiome. Okay, and another question came in about like diet stuff because it doesn’t have the refined sugar. “I drink diet soft drinks. I’m trying to cut back. Still 1 or 2 a day like Coke Zero. Is this okay for my PCOS because there is no sugar in it?” It’s artificial sweetener, right?

SR: Right. So I often tell people if something like that type of a product says no sugar, it’s the biggest bunch of BS that you can see. It just means no sugar but we’ve got something else in here, so it’s artificial sweetener. So that goes back to our discussion about the gut because that type of artificial sweetener is just killing the good bacteria in the gut. That’s not going to be great for them in regards to polycystic ovaries and we know that those types of drinks are related to metabolic syndrome, which again, is underlying insulin resistance and issues with glucose metabolism. So, absolutely not. Unfortunately, those drinks have to go. Things like coffee and stuff, I tell my patients a little bit of that is okay. And I say that because there’s some antioxidants in coffee. There’s something in there that I can find that that’s good. But when it comes to sodas and soft drinks, there’s just nothing. It’s just water and chemicals and junk. I say to my patients, “Do you put oil in your gas tank or petrol tank?” And they say, “No, of course not.” And I say, “Well, why?” They say, “Well, because my car wouldn’t run.” And I said, “Exactly.” By drinking that soda you’re putting oil in your gas tank and eventually, fortunately or unfortunately, it doesn’t happen right away, but eventually your body won’t run the way that it’s supposed to because you’re doing that.

So helping people kind of understand those analogies, but yeah, if they have polycystic ovaries really or trying to get pregnant, soda and soft drinks have been associated with decreased fertility across the board whether you have polycystic ovaries or not.

28:59 CL: I’m glad I brought that up because I think that that could really be, you know, like you try to manipulate information in your mind because you’re trying to hold on to like your old bad habits and going, “Well, if I use like Sweet ‘N Low or something else, it’s not…” you know. So, no.

SR: Yeah. And especially with polycystic ovaries, they’re so much related to sugar. I had one woman who would not give up her quarter teaspoon of sugar in her coffee every day. She’s like, “It’s natural sugar. It’s not…” and I just would shake my head and say you just don’t know if it’s doing anything until you get rid of it. And for whatever reason, she stopped doing it after six months and became pregnant the next month. Now, can I say that was the reason? I don’t know for sure, but what I do know for sure is that when she got rid of it, she became pregnant because probably she decreased inflammation even more than she needed to. So I just say, well, you won’t know until you get rid of it for that 3 to 6 months. So, you want to become pregnant. Are you willing to also become healthier in the process?

30:02 CL: What about things like Stevia or xylitol? What’s your thoughts on that?

SR: So, a couple of things. My patients ask me about that a lot. What I will do is if somebody comes to me and they are drinking the diet Coke or having lots of sugar in their diet and really having a hard time getting rid of it, my next step is to move to things like Stevia and xylitol. What we have to remember is that those things, even though they’re not moving their blood sugars really, they are potentially contributing to those overgrowths, right? So the gut health issues, the candida, that type of stuff potentially. There’s not a lot of really good research on that. So if that person is already using those things, I will get them to come off of it completely. But I’ll use Stevia and xylitol to kind of be that stepdown if somebody is really having a difficult time coming off the very processed, sugary products and artificial sweeteners. But I’d prefer that my patients get off of that so they get away from still that taste of wanting that something sugary. But they don’t have to never eat sugar ever. What I say is, two times a week give yourself a treat during the day. When you have kids, hopefully you’re not going to be giving them treats every single day or a couple of times a day. A treat is a treat because you’re not having it often. So treat your situation that same way and just give yourself a couple pieces of dark chocolate on Tuesdays and Thursdays, you know. And just have that so you’re not completely depriving yourself but you’re also not overwhelming your system so that it wants it more and more and more.

31:41 CL: It’s good to have a conversation around it and give people sort of parameters because, I mean, what do we do and a lot of us are stressed, we’re emotional eaters. And sugar, there is just that comfort connection. That’s why chocolate is so popular, right?

SR: And fruit is a great alternative and if we can do that, if we can train ourselves to have fruit because how many people binge on apples? I mean, not a lot of people but —

32:07 CL: It’s hardly the issue.

SR: Six to seven apples a day. But in that moment of emotional eating or that moment of emotional stress, again, is it our gut that’s kind of dictating what we’re wanting or if it is truly that pattern of that emotional eating, then stopping that pattern with just giving yourself a little bit of that low glycemic sugar that will satiate you for that minute and you can consciously then go, “Okay, I’m good.” That clearly is an emotional step. So you eat with that pattern and throughout that you go, “Okay, I’m going to interrupt this behavior with this,” like the Gymnema we talked about. And even if it’s a piece of fruit to kind of curb that sugar craving and then be consciously able to go, “Okay, no, that’s all I need.”

32:49 CL: That Gymnema, I don’t know if I’m pronouncing that right, it’s on Amazon. There’s a couple of different because I have looked into that. So yeah, thanks for reminding me about that.

A question: “I went to see a functional medicine practitioner after my PCOS diagnosis. She said that my adrenals also need attention and is focusing on my thyroid. She also told me that my boot camp and cross fit classes may be exacerbating my PCOS. Is this true? Because I love them for managing my weight. My other doctor never talked about any of this. I feel like the functional medicine doctor wants me to change everything. Diet, exercise, adding meditation, adding supplements — is this all really going to help? I’m willing if it is.”

SR: Well, definitely. It’s about getting healthier. All that stuff certainly is going to help but I would disagree with the person who said that the boot camp and — what was it? Boot camp and?

33:47 CL: Cross fit. Cross fit is very popular, yeah.

SR: Cross fit was making the PCOS worse? I would have a hard time with that. However, if they’re over exercising or exercising too much, if they’re adrenally fatigued and they’re kind of beating a dead horse by exercising too much and their body is not able to recover from that exercise. The cortisol levels are too low and they’re not able to really recover from that. Then potentially that exercise could be keeping them in more of an adrenal fatigue or adrenal exhaustion phase which as you and I know that that could then impact the thyroid health as well. So your thyroid and your adrenals are not necessarily like brother and sister but they’re close cousins. So if you’re really, really rundown, what’s the body’s best way to control or to conserve energy? Well, it would be to slow down the engine of the body which would be the thyroid. So your adrenals is sending that signal to the thyroid or affecting how the thyroid hormone converts from one to the other etc. Well, it will have that effect potentially in some people slowing down thyroid function so you’re feeling more tired. And why does the body want you to feel more tired? Well, so you conserve more energy and you stop pushing yourself. But we don’t do that; we just keep pushing the adrenals. And it’s just a vicious cycle.

35:03 CL: Especially if you’re so worried about weight gain and feeling like “I need to do these real extreme type exercises.”

SR: And the research behind exercise and fertility is mostly done for women who are going through IVF, but we can talk about that for a moment. So the research shows that 30 to 40 minutes 4 or 5 times a weeks of moderate exercise is most beneficial in regards to women going through IVF and trying to become pregnant. So we could equate that to just fertility in general. But what is moderate exercise? That’s what my patients will ask me. Well, it kind of depends on the person. If this person is doing cross fit and they’re feeling amazing the next day, they’re probably doing great with the amount of exercise that they’re doing. As long as their hormone levels match that. So if their hormone, estrogen, progesterone are pretty good, it doesn’t look like that exercise is also suppressing them, then I would say, “Hey, go for it. I want you to move.” If though they’re doing the cross fit and they’re still dragging the next day or that day they’re dragging, and they’re themselves out of bed and they can barely get to the gym, and they just don’t feel the benefit of having the exercise because they’re so tired. Or if they’re constantly getting sick like I went through a phase of adrenal fatigue where I was so exhausted because I was running myself into the ground. Whenever I would exercise, I would get sick within 1 or 2 weeks. I never got sick before, but it was my body telling me “Hey, your petrol tank or gas tank is empty and you’re trying to push beyond that.”

So again, it’s more of an individual prescription, isn’t it, about how much exercise that person should do based on how they’re feeling. And if my person is significantly adrenally fatigued or exhausted, I mean, I want them to curb their exercise but I would never because I love exercise so much myself, I would never tell them don’t exercise at all. And certainly with polycystic ovaries because you need exercise to help improve that glucose metabolism to utilize the insulin and just decrease the insulin resistance. So we want them active in some form. That’s another way that we can work together with the patient to find what’s best for them.

37:11 CL: A couple of things come to mind kind of working backwards. But I think that there’s like these messages. Maybe they came out of the ‘80s, like I’m thinking Jane Fonda videos, like feel the burn, no pain no gain. So people can feel sort of depleted from exercise but feel like that’s the process of or that they’re just out of shape, but the truth is, many of us have adrenal issues and some of those exercises are a little too extreme for your condition. But then if you’re focused so much on, “Oh my gosh, I need to do these types of exercises because I can’t control my weight.” I think really going back to the anti-inflammatory diet, the blood sugar balancing diet, that’s an incredible way to stay at a good weight for you.

SR: Absolutely.

38:02 CL: And you could do like restorative walking or yoga and really maintain the weight.

SR: Absolutely, yeah. And the person might enjoy that higher intensity exercise and, you know, like you said, where does it come from? It’s more societal because where were we ever taught growing up to listen to your body. Listen to your body.

38:21 CL: Yeah, you got to push past that.

SR: Yeah. No one will tell you don’t listen to your body. Push past it and get that. And to a certain extent, okay, yeah, some people would need to do that because they’re just not going to push themselves at all. But to tell that to everybody especially that person that is just pounding it every single day and just is not finding the time to restore their energy is difficult. And outside of PCOS, or I should say including the PCOS but including all fertility, there’s plenty of women that exercise like crazy and there’s plenty of women that drink artificial sweeteners. There’s plenty of women that do the other things that we tell our patients not to do and they’re getting pregnant. So the patient is going, “Well, why do I have to do this?” At least in polycystic ovaries, they have something that they go, “Well, you’re doing this also to decrease the issues that are creating the polycystic ovaries which then potentially is impacting your fertility. But it’s those that don’t have that diagnosis, it’s harder for them to go. My next-door neighbor drinks a pint of tequila every other day and they have five kids. You’re telling me I can only have a couple glasses of alcohol?

39:31 CL: I know. That’s tough.

SR: But we’re all different. We have a different makeup.

39:35 CL: We’re all different. Another thing is it’s all about having a healthy pregnancy, a healthy baby, while maintaining your own health and then that baby comes out and is a self-sufficient human being.

SR: Long-term health.

39:52 CL: Yeah. With like eczema, food allergies, learning disabilities, I mean, so that’s kind of coming out too. I’m not saying it’s happening across the board but it’s just the end goal should not just be getting pregnant because believe me, you have to be a caretaker of that baby and if you’re feeling depleted, it’s rough to do that.

I don’t want to beat a dead horse but we’re going to talk about it again. When we’re talking about adrenals and thyroid, honestly, I don’t know many conventional doctors that do the proper testing of the thyroid antibodies and then the full thyroid workup and then doing like a cortisol panel where often you have to do multiple times a day. So if you’re listening and, “Well, I don’t know if I have thyroid and adrenal issues. My doctor said I’m fine.”

SR: “My thyroid is fine.”

40:46 CL: Yeah. So you might need to delve into that deeper by going to a functional medicine practitioner who can really do a proper workup. You deserve it and they can give you a lot of information.

SR: That’s a whole podcast on its own, just that small topic. We could talk for hours on it.

41:04 CL: Yeah, absolutely. Okay, a question: “I’ve had several miscarriages. My doctor said that PCOS increases your chance of miscarriage. What do I do to decrease it with this diagnosis?”

SR: Sure. So polycystic ovaries in some cases can increase your risk of miscarriage but it’s not necessarily again the polycystic ovaries. So polycystic ovaries is associated with increased risk of miscarriages, not necessarily the cause. The underlying issues are potentially the cause. So we go back to thyroid which is very, very often related to several miscarriages. We go back to things like thyroid antibodies, which you mentioned, can also be related to miscarriage, so that’s an autoimmune issue that should be ruled out. And these are more common in women with polycystic ovaries. Then we go back to the insulin resistance which we know women who are diabetic would have a greater incidence of miscarriage potentially as well if their blood sugar and insulin levels are not controlled well.

So again, we have to get away from thinking of polycystic ovaries as something completely separate. So it’s not the PCOS that potentially is the issue. It’s the underlying issues that are contributing to the miscarriages So working with somebody who can research and figure out what those underlying issues are for you and then create that program specific to your situation is going to help decrease your risk of miscarriage then. And there are other reasons for recurrent miscarriage but that’s kind of out of the scope of this talk.

42:40 CL: “Diagnosed with PCOS. Been trying to conceive for 3 ½ years and I’ve almost given up hope. Should I keep trying and for how long?” How do you answer to that?

SR: Right. So if you’re trying for that long period of time, my first thing would be, do you have a regular cycle? Because here’s the other thing that’s often missed with polycystic ovaries, is male fertility issues. So oftentimes when there’s just a diagnosis of the woman, otherwise it’s unexplained but then they discover that a woman has polycystic ovaries, the guy gets forgotten. So he may be a smoker or drinker, 25 pounds overweight, but if he has X amount of sperm, everything should be fine. That’s not necessarily the case. But we as women tend to take it on ourselves and be like, “It must be my problem. His numbers are okay.” Well, his numbers are basically 3 numbers that they look at. They don’t delve any deeper than that which they should. They only look at the count, how well the sperm swims, and the shape of the sperm. And more and more studies are showing that that’s not good enough to determine whether or not the sperm is good enough to contribute to a viable pregnancy. So I’m going to be wanting to talk to them about the partner and see if he can follow the program as well.

In regards to how long you should try for, that’s a personal decision. So it might be different if you’re 27 and have been trying for 3 years, or 47 and trying for 3 years. So that’s a real personal decision that you and your husband have to sit down or you and your partner have to sit down and talk about and say, “If we became pregnant 6 months to a year which it might take to optimize their situation, is that okay with us?” So it’s hard to answer that question about how long that specific person should try unless I’m sitting there, helping them work through what they feel is best for their situation. Because it’s not my place to tell them how long to try. But is there still hope after trying for 3 ½ years? Absolutely. Without knowing where they’re at and, again, how their cycles are, any of the other things that are going along with it, there are certainly many things that can be looked at. I had patients trying for 9 years and come to us and become pregnant. So it’s something that certainly can be improved upon for sure. You just have to find the person that’s looking at you holistically and not just looking at one blood test or telling you to do this one procedure. Just go ahead and do this procedure. It doesn’t work. Okay, well, your eggs must be too old or they must not be healthy because you have polycystic ovaries. That’s not good enough. It’s just not good enough.

45:17 CL: You did a great job answering that question because there are so many unknowns in that person’s situation and what kind of support they’re getting. Yeah, and I think like women sometimes go to an IVF clinic and get evaluated and then they don’t fit their criteria. I mean, obviously, IVF clinics, they want to have a good success rate and if you don’t fit it somehow, then they feel like, “Well, I can’t do that and I’ve tried. It’s just a no-go for me, like a dead-end street.” Which is really not true. Not a good candidate for IVF? You could be a great candidate for natural fertility. You just need to make some changes.

What supplements are found to be effective in the treatment of PCOS and are they necessary?

SR: Well, how long is a piece of string? So again, it depends on the particular person and what they’re presenting with. So I don’t recommend the same supplement for every one of my patients with polycystic ovaries. It will depend on what their thyroid is doing, how their adrenals are, how their reproductive hormones are, do they have regular cycles, sugar issues like we talked about. So I’d be very specific in things that I recommend. I don’t like it when my patients come in with a bucket full of supplements to say that, “Well, this is what my last person gave me.” So I try to streamline that process because me personally, I take supplements. I don’t want to take 50 a day. So I try to streamline it for that purpose, for compliance, but also for cost. It’s not cheap. So we try and get the most cost effective supplementation that’s specific for that person’s particular situation.

And then there’s a question of whether they’re utilizing Clomid because Clomid is something that can help with ovulation. Or Femara, they might be taking that. There are good studies showing that if they’re Clomid-resistant, like they’re not ovulating on Clomid or they’re not consistently ovulating on Clomid, there are certain herbs or supplements that can be used along with the Clomid to help to make the Clomid work better or to help them ovulate and be able to time intercourse more efficiently. That doesn’t really get to the underlying issue, right? So if they’re becoming pregnant on the Clomid, they’re really not addressing the underlying issue which is a concern for gestational diabetes in pregnancy, high blood pressure, all those types of things. But certainly if there’s that person that really wants to take the medication, there are supplements and/or herbs that can be utilized to help with that. But I always have the conversation about this is a lifelong issue. Let’s try to look at the underlying issues as well too. And sometimes they just have to go through the Clomid phase or the IVF and it doesn’t work for them and then they’re willing to give it some time from a natural point of view. And everyone’s on their own journey, so I’ll support them no matter what they decide and let them know that I’m here if it’s not working to come back and we can look at that. But yeah, I wish I could give very specific recommendations for supplementation for those who are listening but I just can’t because everyone is so different in how they present.

48:24 CL: This is a question I had forgotten to add, but I don’t know if you come across this. It was a woman diagnosed with PCOS when she and her husband were trying to start a family. She felt sort of devastated and scared to tell him. Like he didn’t really know the impact of it. She was told that she had PCOS, but she just couldn’t tell him that it could potentially make it difficult to have a child. Do you come across that where women go, “Yeah, my husband knows I have this but they don’t really…” Like, my husband relies on me for the research, so whatever I have, like I pretty much have to fill him in, how it’s going to impact us as a couple. It’s like I can kind of see that that would be a difficult conversation because there’s a little bit of the unknown in, you know.

SR: Sure. It depends on the relationship. If somebody is not able to tell somebody else who’s that close to them, my first question to them would be, not how do you feel about it but how is it impacting you. Because if you’re not able to verbalize that to someone who is so close to you is, A, is your relationship strong? Because that should be the person that you should be able to talk these things about. And if your relationship is strong, what within yourself are you worried about, about you that might change if you tell your partner this? Is it the way that they’ll look at you, is it that it’s your fault? So if you have those types of thoughts of whether “That’s my fault”, “If I kind of admit this or if I tell anybody,” you have to look at there’s two things here. There’s an egg and a sperm that need to be healthy in order to create this. So even though there’s a diagnosis, it doesn’t mean that that’s the absolute reason. There’s so many different variables that go into creating a viable pregnancy, that if you’re in a partnership where you care and love each other, you should be supporting each other regarding your health or raising your child. What’s going to happen if the child has some issues? Are you not going to want to tell your partner about that because you’re afraid?

So really figuring out what that underlying reason is of them not wanting to tell their partner and then helping them sort through that, or recommending that you see someone, therapy to help them sort through that, whichever is most appropriate. So that’s how I would handle that situation.

Then also, people with polycystic ovaries sometimes will have this kind of self-esteem issue f being different, not being normal. Having the excessive hair growth or that acne, that can create real huge self-image issues and contribute to issues with self-esteem. So bringing that to the patient’s attention and again looking at things holistically because they may be ashamed. So, may sound silly to somebody else, “Oh, I can’t believe you wouldn’t tell your partner,” but they may be ashamed of that and it’s not something that they feel real comfortable talking about. They have probably other self-image issues or potentially, I don’t know in that particular case, but those are all the kind of things that I’m thinking about if somebody were to talk to me about that. Because I want to be able to not just give them vitamins and swing by. I really want to feel like they’re coming to a place of support where they can feel like I’m looking at them not just from a physiological perspective but from an emotional perspective as well and helping them through as well.

51:55 CL: A word that comes to mind because I was reading about something, what sort of motivates us and a sort of an unhealthy motivation is that fear of abandonment.

SR: Right. For sure, yeah.

52:07 CL: Something that a person just can’t handle about us and leaving. Even though that may be far from the case with your spouse. “That’s crazy that you would think that.” It’s just that there’s that inner… I’ve experienced that myself where like, “Wow! That’s what’s going on with me.” You’re so scared that a person just couldn’t stick with you during whatever.

SR: Right, exactly. Then that’s usually, like you said, if it’s not really the case truly, there’s usually some underlying issue of “I’m not good enough just on my own” for that person to stay. You know what I mean? So that would be to be able to work through that with someone would be hugely important because I guess this is how I look at the patients that I’m dealing with fertility issues. I talked about before about the physician who has a missed opportunity of talking to that teenager who has polycystic ovaries. There’s so much that can be done at that point in time. Whereas I look at my practice as I absolutely want to help and support my patients to become pregnant. First and foremost that’s why they’re coming to me. But if I can be a cog in the wheel of helping them also improve the rest of their life and give them a little bit of support for how they then support their family in turn, then I think I’m really doing my job. Not just focusing only on pregnancy but focusing on the person as a whole. And not everybody is ready for that. People just want to come to me to get pregnant, and that’s okay too. I try to meet everybody where they’re at and if somebody is ready or needs that support, then I can provide that or give them suggestions of where to go to find it.

53:43 CL: How do we find out more about you? You said you renamed your book.

SR: Oh, sorry. I have to update my bio. Thanks for bringing that to my attention. My new book came out. Basically, The Fertility Bible was a bestselling book in Australia. It was fantastic. It was 165 pages and I felt like it just didn’t have enough meat, so I renamed it to kind of reflect our Baby Maker products brand here in the US called The Baby Maker’s Guide to Getting Pregnant: Featuring the Five-Step Fertility Solution. It’s available on Amazon. And then I have some thermometers, fertility thermometers and ovulation tests under the Baby Maker brand on Amazon as well. If you want to get in touch with me in regards to consultations or just any other information regarding what we do in our program, it’s Naturalfertility.com. It would be a way to look at our website. If you’re a practitioner, we have The Baby Maker Network. So both Baby Maker Community and Baby Maker Network are also on Facebook. If you wanted to like us on Facebook, that’s another way to keep in touch with me. But yeah, practitioners, we have a 12-month program to go through all different facets of fertility, 5- to 6-hour webinars on each topic and really going into very much in-depth on the newest research out there about fertility. And then the consultation services that we have are really related to our Five-Step Fertility Solution and then suggesting specific herbals and supplementation for their particular situation. So they can reach me at Stacythebabymaker@gmail.com, that’s an email that they can reach me at. Or info@naturalfertility.com.

55:39 CL: You got all the great domain names and the “baby maker”. Okay, I’m going to put those in the podcast notes and not to put you on the spot, but is there like, I don’t know, just a line of inspiration that you can give? I think the takeaway of all this is you are not your diagnosis, right?

SR: Correct.

56:03 CL: And so it’s a group of signs and symptoms that can be managed. You can be stronger, healthier. You can come out the other side of this incredibly healthy. But is there like an inspirational something you can leave us with?

SR: I think along those lines of what you said ‘you aren’t your diagnosis,’ I think we’ve got to stop looking at polycystic ovaries as some separate entity that needs to be addressed or is impossible to be addressed in regards to fertility. It’s really just the canary in the coalmine and if you remember what that means, it’s back in the day before they had things to detect poisonous gases and coalmines, they would take a canary down there and if the canary dropped dead basically, then they know that couldn’t work in the coalmine that day. PCOS is the canary in the coalmine and the positive take to be diagnosed with polycystic ovaries when you’re in your 20s or 30s and trying to get pregnant is that you have the ability to change your life and your health for the long-term because you’ve been let know early on that you have propensity to this issue so you can avoid being diagnosed with diabetes, avoid being diagnosed with high blood pressure. You can avoid potentially your children having to deal with these same things. So being able to take responsibility for your health is not just going to be a gift that you give yourself. It’s going to be a gift that you give your family as well. So keeping that in mind that there’s so many things to do and that your actions will have repercussions going forward many, many, many years is something to keep in mind when you’re diagnosed with polycystic ovaries. And you have an advantage of knowing now so you can do something about it that’s significant.

57:44 CL: Absolutely. Thanks. And don’t leave out us first-time moms that are in our 40s too because you can improve your health.

SR: Right. The reason why I didn’t mention that is because I don’t see a lot of polycystic ovaries being diagnosed for the first-time related to fertility in the 40s. Usually they’re diagnosed a little bit earlier. In the 20s and 30s is where I see most of my polycystic ovary patients. However, you’re right. I see women in their 40s becoming pregnant. And when you look at the statistics, the women between 35 and 40 are becoming pregnant more than anybody else and women between 40 and 45 are becoming pregnant 8 to 10 times more than they were 40 years ago or even 10 years ago. Thanks for bringing that to my attention. But it’s so important to for us to understand that yeah, there is a pointy end of the stick where things aren’t going to work anymore but it’s not 35. It’s not even 40 in some cases for many people. Once you get to mid-40s and above, that’s where we seem to have a lot of problems or more challenges, I should say, to becoming pregnant. But yeah, absolutely there’s so much potential.

58:59 CL: That was a great conversation. I learned a lot.

SR: It really was. Thank you so much.

59:02 CL: Oh, and one thing. The metformin depleting folic acid and B vitamins, I mean, when women are put on that, they might not get that piece of information right and those are crucial nutrients for fertility.

SR: Absolutely.

59:20 CL: I just wanted to kind of, you know, there was so much information covered to bring that up again.

SR: Absolutely. So they need to be taking something with calcium to help the B vitamins and things get absorbed from the foods that they’re taking but also they need to have their folic acid and B vitamins as well along with that. So it’s very important to consider that in your supplementation program.

59:40 CL: Thank you so much, Stacey. I really enjoyed it. And I’ll tell you when this episode is published.

SR: Sounds good. Thank you.

59:47 CL: Thank you so much. Bye-bye!

SR: Nice to meet you. See you!

59:50 CL: Nice to meet you.

SR: Bye-bye.

59:51 CL: Bye.